

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN"
      "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">

<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en">
    <head>
        <meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
        <title></title>
    </head>
    <body>

        <h1>PhP Sub shop</h1>
        <!-- form to gather user information -->
        <form action="script.php" method="post">
            
            <p><label>First:</label> <input type="text" name="fname" />
            <label>Last:</label> <input type="text" name="lname" /><br />
            <label>Address:</label> <input type="text" name="add" /><br />
            <label>Phone:</label> <input type="text" name="phone" />
            <label>City:</label> <select name="city">
                <option>Tallahassee</option>
                <option>Moticello</option>
                <option>Havana</option>
            </select></p>

            <p>
            <label>Sub:</label><br />
            <input type="radio" name="sub" value="turkey" />Turkey<br />
            <input type="radio" name="sub" value="ham" />Ham<br />
            <input type="radio" name="sub" value="roast beef" />Roast Beef<br />
            <input type="radio" name="sub" value="meet ball" />Meat Ball</p>

            <p>
            <label>Toppings:</label><br />
            <input type="checkbox" name="t1" value="lettice" />Lettice<br />
            <input type="checkbox" name="t2" value="tomato" />Tomato<br />
            <input type="checkbox" name="t3" value="cheese" />Cheese<br />
            <input type="checkbox" name="t4" value="pickles" />Pickles<br />
            <input type="checkbox" name="t5" value="onion" />Onion</p>

            <p>
            <label>Drink:</label>
            <select name="drink">
                <option>Coke</option>
                <option>Tea</option>
                <option>Sprite</option>
            </select></p>

            <p>
            <label>Note:</label><br />
            <textarea name="note" cols="40" rows="4"></textarea></p>

            <p><button type="submit">Submit</button></p>
        </form>
    </body>
</html>
